| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INS OPTIONS OF THE CAROLINAS INC3 | 1326 CAVENDISH CT CHARLOTTE, NC 28211 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $37K | $0 | $37K | 18.95% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $14K | $14K | 7.02% |
| INS OPTIONS OF THE CAROLINAS INC3 | 1326 CAVENDISH CT CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $113 | $5K | 10.23% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| INS OPTIONS OF THE CAROLINAS INC3 | 1326 CAVENDISH CT CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $211 | $5K | 10.49% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| INS OPTIONS OF THE CAROLINAS INC3 | 1326 CAVENDISH CT CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $63 | $2K | 15.57% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $579 | $579 | 5.00% |
| INS OPTIONS OF THE CAROLINAS INC3 | 1326 CAVENDISH CT CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $766 | $34 | $800 | 10.44% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $383 | $383 | 5.00% |
| INS OPTIONS OF THE CAROLINAS INC3 | 1326 CAVENDISH CT CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $458 | $30 | $488 | 10.66% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $229 | $229 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ADMIN AMERICA, INC. HRA ADMIN | Claims processing Service code 12 | 1720 WINDWARD CONCOURSE SUITE 290 ALPHARETTA, GA 30005 | $5K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 MEDICAL CARRIER | Claims processing Service code 12 | — | $2K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 152 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 118 | $195K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $49K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $5K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 70 | $43K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.